Oral Health Perceptions and Practices of Caregivers at Children’s Madrasas and Foster Care Centers: A Qualitative Exploratory Study in Lahore, Pakistan

Abstract Background:Oral diseases are one of the major public health problems worldwide which are affecting the population of all age groups. This qualitative study aimed to explore the perceptions and practices of caregivers at the care centers managing children’s oral health.Methods:A qualitative ethnomethodological approach was used to collect data from the caregivers at the child healthcare centers. A convenience sampling technique was used to conduct focus group discussions comprised of 4-7 caregivers from five foster care centers located in Lahore, Pakistan. An inductive-deductive approach was used to generate data by using a semi-structured interview guide. A three steps thematic analysis was applied to develop codes that were merged to generate categories and to conclude into themes from the transcribed data.Results:Five focus group discussions were conducted at two foster care homes (FG1 & FG2) and three madrasas (FG3, FG4 & FG5). Foster care homes had children of both genders within the same premises, however, madrasas had segregated settings. Four themes emerged from the thematic analysis providing a thick description of foster caregivers to maintain the oral health of the children. Children induction policy outlines the foster care environment and caregivers' perceived oral health severity defines their hygienic practices A socially conducive oral health knowledge, and integrative medicinal approach to treat oral health issues were evaluated.Conclusions:This qualitative study provided a multidimensional assessment of foster caregivers to maintain children’s oral health. With stringent induction policies, the foster care centers had better control over the children to maintain healthy oral health practices. Fostercare givers perceived severity about oral health issues and type of fostercare center defines the hygienic and medicinal practices.